Breakups aren’t easy, and I’m often on the receiving end. Getting dumped in a romantic relationship can be child’s play compared with ending a relationship with a doctor, especially when a chronic disease is involved.
This year, I’m faced with replacing almost half of my extensive medical team. My primary care physician, dermatologist, and hepatologist have moved on to new endeavors.
Established relationships with healthcare providers can be essential for successfully treating patients with chronic diseases like IBD. That’s why searching for a new physician can be as perplexing as dating.
My primary care physician and the old switcheroo
During my annual physical last year, my primary care physician told me she was retiring. I wasn’t too distraught. Our relationship was more of a formality because I needed a primary care doctor under my insurance plan. She was my physician of record for longer than I can remember, but I only saw her when I needed a referral to see a specialist or had a cold or a cough.
Her official retirement announcement listed recommendations for internal and family medicine doctors. Both provide routine physicals and similar services. However, internists treat adults 18 and older, unlike family doctors, who treat patients of all ages. Also, the American College of Physicians explains that internists specialize “in the diagnosis of puzzling medical problems, in the ongoing care of chronic illnesses, and in caring for patients with more than one disease.”
With my complex medical history, I needed to continue my care with an internist, and I made an appointment for my physical in October. Before we could meet, the clinic rescheduled me with a different internist because my first choice was only doing telehealth.
My hunt for a primary care physician was beginning to resemble a romantic comedy trope in which someone’s blind date switches places with a friend. Girl makes an appointment with doctor. Doctor convinces another doctor to meet girl. Girl unknowingly falls for the stand-in. I’ll have to see if this old switcheroo ends in happily ever after.
Swiping right to find a dermatologist
My dermatologist ended our relationship with a form letter. He was leaving for a better opportunity, the typical “it’s not you, it’s me.” Our two-year fling started after my liver transplant. I started seeing him because my anti-rejection medication, tacrolimus, increases my risk of skin cancer.
My former primary care physician set us up, so I couldn’t ask her for a recommendation. Instead, I searched online. I wanted to stay within the health system so I wouldn’t need to transfer my records. Also, because my dermatologist and primary care physician belong to the same system, they could easily coordinate my care if necessary.
I browsed the provider bios in my patient portal and clicked the one I thought I would be compatible with. I’ll find out in a few weeks if my new dermatologist lives up to her online persona.
My hepatologist is into the group thing
When a breakup blindsides me, I’m left reeling with uncertainty. This happened with my transplant hepatologist.
I noticed something was off when I logged into my telehealth appointment with her to discuss my elevated liver enzymes. Her nurse practitioner greeted me instead because my doctor had already left for the day.
After my liver biopsy a month later, her other nurse practitioner called with the results. She also broke the news that my hepatologist was transitioning to part-time to focus on her family and on research. I assumed my hepatologist would continue seeing me. However, a few weeks later, she sent a letter introducing her colleague who would be taking over her patients.
I was in a conundrum. Should I stay with my transplant team, located almost 100 miles away in San Antonio, Texas, or use this opportunity to find a hepatologist closer to home? Could a fresh start with a new team provide a more objective, second opinion? Either way, I would have a new hepatologist.
At my appointment with my gastroenterologist last week, I asked for his opinion because he conversed frequently with my hepatologist about mutual patients. He advised me to remain with my team because of their familiarity with my case.
When he told me he had spoken with my former hepatologist about me the previous day, it cemented my decision to stay. Even though I had a new primary hepatologist, I realized my former doctor would be monitoring my care behind the scenes.
Managing my gastrointestinal health is a group effort. Building a relationship with a new team of specialists would be more complicated than adjusting to a new doctor.
Like all first dates, the initial appointment with a new physician can end in disaster or be the start of a beautiful relationship. Finding “Dr. Right” takes time and patience. But once I find that special someone, I’m in it for life.
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